Which of the following medications should generally be avoided in elderly patients due to potential side effects related to confusion?

Diphenhydramine is an antihistamine that is often associated with sedative properties, leading to increased risks of confusion, sedation, and falls in elderly patients. The elderly are particularly susceptible to the anticholinergic effects of diphenhydramine, which can exacerbate cognitive impairment and increase the risk of delirium. This makes it especially contraindicated for use in this population.

In contrast, while Valium, Zolpidem, and Temazepam can also cause sedation and confusion, they are typically prescribed with more consideration regarding the dosage and potential side effects in elderly patients. However, they can still pose risks that necessitate careful monitoring. Diphenhydramine, due to its widespread availability and common use for allergies and sleep disturbances, is more frequently recommended to be avoided altogether in the elderly due to its significant side effects. Therefore, the use of diphenhydramine should be limited in older adults to reduce the risk of confusion and related adverse effects.